Rheumatic Fever

Question 1

What is rhuematic fever

Answer 1

Autoimmune condition, multisystem disorder causing inflammtion

Question 2

Cause of rheumatic fever

Answer 2

Streptococcus bacteria

Question 3

How does the response to the bacteria cause a reation

Answer 3

Antibodies against the bacteria also target body tissues

Question 4

How long after infection does rheumatic fever occur

Answer 4

2-4 weeks after intial infection

Question 5

What type of hypersensitivity reaction is RF

Answer 5

Type 2 - immune system attacks own body cells

Question 6

Presentation of rheumatic fever

Answer 6

Fever, joint pain, rash, SOB, chorea, nodules, joint, heart, skin and nervous system involvement

Question 7

Joint involvement in RF

Answer 7

Migratory arthritis, different joints inflamed at different times, swollen, hot, painful joints.

Question 8

Heart involvement in RF

Answer 8

Carditis, pericarditis, myocarditis, endocarditis, which can lead to tachy/bradycardia, murmurs, pericardial rub and HF

Question 9

Skin involvement in rheumatic fever

Answer 9

SC nodules and erythema marginatum. Firm painless nodules and pink rings affecting torso and limbs

Question 10

Investigations into rheumatic fever

Answer 10

Throat swab, ASO antibody titres, ECHO, ECG, and CXR for heart involvement. Jone’s criteria fro diagnosis - major and minor

Question 11

Jone’s major criteria (JONES)

Answer 11

Jones arthritis.
Organ inflammation.
Nodules.
Erythema marginatum rash.
Sydenham chorea

Question 12

Jone’s minor criteria (FEAR)

Answer 12

Fever
ECG changes
Arthralgia without arthritis
Raised inflammatory markers

Question 13

Management of RF

Answer 13

Eradication of strep infection, prevention of permanent cardiac damage, NSAIDs, aspirin and steroids for carditis, prophylactic antibiotics

Question 14

Complications of rheumatic fever

Answer 14

Recurrence, valvular heart disease, mostly mitral stenosis and chronic heart failure